Journal of Urology最新文献

{"title":"A Randomized Controlled Trial of Ultrasonic Propulsion-Facilitated Clearance of Residual Renal Stone Fragments vs Observation.","authors":"Claire C Yang, Elizabeth E Keating, Ravi Managuli, Nancy Honssinger, Sarah K Holt, Alana C Desai","doi":"10.1097/JU.0000000000004501","DOIUrl":"10.1097/JU.0000000000004501","url":null,"abstract":"<p><strong>Purpose: </strong>In patients with residual stone fragments, ultrasonic propulsion (UP) increased the fragment passage rate by 58% and reduced risk of relapse by 70% vs untreated controls with minor associated adverse events (AEs). This study presents a second, independent trial of UP to demonstrate replication of those results and effective training of a novice team of users.</p><p><strong>Materials and methods: </strong>This was a multicenter, prospective, open-label, randomized, controlled trial. Adults with residual fragments ≤ 5 mm seen on clinical imaging at least 4 weeks post lithotripsy were enrolled. The treatment group underwent UP; the control group did not. The effectiveness end points included the proportion of subjects reporting visual observation of stone passage within 3 weeks post procedure (treatment group) or randomization (controls) and the reduction in stone burden on follow-up imaging captured within 90 days post procedure/randomization. The safety end points were AEs within 3 weeks post procedure/randomization. The Fisher exact test was used for comparison.</p><p><strong>Results: </strong>The trial was conducted April to October 2024. Fragments remained a median of 6 months after surgery before study enrollment. Ten of 12 treated participants passed fragments vs 2 of 12 controls (<i>P</i> = .003). Nine of 12 treated participants saw stone burden reduction on imaging vs 1 of 11 controls (<i>P</i> = .003). All AEs were mild, occurring in 7 of 12 treated participants and 4 of 12 controls.</p><p><strong>Conclusions: </strong>Consistent with the index study, UP conducted by an independent group of operators demonstrated a higher rate of fragment passage and greater reduction in stone burden after UP compared with controls, with minor associated risk.</p>","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"3-9"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MP33-05 Single-Use Cystoscopes Offers Faster Time-to-Scope With Equivalent Perceived Functionality vs Reusable Scopes in the Inpatient Setting: Erratum.","authors":"Stephen Hassig, Matthew Steidle, Carl Ceraolo, Jason Fairbourn, Denzel Zhu, Ashley Li, Galen Chen, Kelvin Lim, Christopher Wanderling, Aaron Saxton, Laena Hines, Trevor C Hunt, Mark Ninomiya, Austin Lee, Rajat Jain, Scott O Quarrier","doi":"10.1097/JU.0000000000004496","DOIUrl":"https://doi.org/10.1097/JU.0000000000004496","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":"214 1","pages":"112"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostate Size and Its Effect on Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia Improvement After Convective Water Vapor Thermal Therapy.","authors":"Owen Lewer, Michael D Felice, Olivia Copelan, Sarang Janakiraman, Gaurav Pahouja, Amy Wozniak, Kevin T McVary","doi":"10.1097/JU.0000000000004516","DOIUrl":"10.1097/JU.0000000000004516","url":null,"abstract":"<p><strong>Purpose: </strong>Lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) affect quality of life. Convective water vapor thermal therapy (CWVTT; Rezūm) is a minimally invasive surgical treatment for LUTS/BPH which produces significant improvement of LUTS in men with prostates between 30 cc and 80 cc with minimal de novo sexual dysfunction. However, outcomes across the prostate volume (PV) spectrum are incompletely described. We aim to elucidate the relationship between PV and outcomes post CWVTT in men with LUTS/BPH.</p><p><strong>Materials and methods: </strong>Patients undergoing CWVTT at a tertiary care center were included. The primary outcome was change in International Prostate Symptom Score (IPSS) pre CWVTT compared with post CWVTT between PV tertiles-small (≤38.5 cc), medium (38.5 to ≤55.6 cc), and large (>55.6 cc). Secondary outcome was time to a minimally clinically important difference of 25% decrease in IPSS.</p><p><strong>Results: </strong>One hundred seventy-one patients were divided into small (n = 56), medium (n = 54), and large (n = 61) PV tertiles. The change in IPSS preoperatively to 3 months was significant for all tertiles with mean difference of -7.51 (-10.14 to -4.83), -10.12 (-12.71 to -7.53), and -11.72 (-14.14 to -9.29) for small, medium, and large PVs, respectively (<i>P</i> = <.001). In multivariable analysis, having diabetes was associated with increased IPSS after 3 months with average increase (95% CI) of 3.67 (0.23-7.11, <i>P</i> = .037) compared with not having diabetes. The median time (Q1, Q3) to -25% in IPSS for small, medium, and large PVs was 16.1 (12.1, 17.5), 12.3 (7.1, 15.7), and 13.8 (10.8, 16.3) months, respectively. In multivariable analysis, medium PV had significantly increased incidence of 25% decrease compared with small PV (HR [95% CI]: 2.10 [1.19-3.72], <i>P</i> = .011).</p><p><strong>Conclusions: </strong>CWVTT results in significant and durable LUTS improvement across the PV spectrum. All PVs experience the same improvement in LUTS post CWVTT. However, medium and large glands may improve more quickly than small glands.</p>","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"48-57"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trauma, and Genital and Urethral Reconstruction.","authors":"Sean P Elliott","doi":"10.1097/JU.0000000000004447","DOIUrl":"10.1097/JU.0000000000004447","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"108-109"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid 3-Tier Bladder Cancer Grade: The Mutually Beneficial Marriage of 2 Grading Systems.","authors":"Ashish M Kamat, Bas W G van Rhijn, Theodorus Van der Kwast","doi":"10.1097/JU.0000000000004542","DOIUrl":"10.1097/JU.0000000000004542","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"92-93"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply by Authors.","authors":"John K Weaver, Joseph Logan, Jason P Van Batavia, Dana A Weiss, Christopher J Long, Ariana L Smith, Stephen A Zderic, Zoe Gan, Karl Godlewski, Reiley Broms, Maria Antony, Maya Overland, Tyler Gaines, Dennis Head, Lauren Erdman, Bernarda Viteri, Madalyne Martin-Olenski, Jing Huang, Yong Fan, Gregory E Tasian","doi":"10.1097/JU.0000000000004571","DOIUrl":"10.1097/JU.0000000000004571","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"88-89"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Impact on Patient Routines/Responsibilities for Surgery and a Nonsurgical Primary Treatment Option in Recurrent Low-Grade Intermediate-Risk Nonmuscle-Invasive Bladder Cancer: Findings From the ENVISION Phase 3 Trial.","authors":"Angela M Stover, Dana Mueller, Jessica Carda-Auten, Alison Hilton, Victoria Tsurutis, Angela B Smith","doi":"10.1097/JU.0000000000004511","DOIUrl":"10.1097/JU.0000000000004511","url":null,"abstract":"<p><strong>Purpose: </strong>Adults with low-grade intermediate-risk nonmuscle-invasive bladder cancer commonly ask urologists how their routine/responsibilities will be affected by treatments, including the standard of care, transurethral resection of bladder tumor (TURBT). We asked patients in the ENVISION trial to compare TURBT with a nonsurgical primary treatment (UGN-102 containing mitomycin) for acceptability and impact on their routine/responsibilities.</p><p><strong>Materials and methods: </strong>ENVISION is a phase 3, single-arm trial where UGN-102 was administered as 6 weekly intravesical instillations. Interviews with US patients were conducted at enrollment (before instillations) and 3 months (primary trial end point). Transcripts were coded by 3 coders using the gold standard of content analysis to derive interview themes.</p><p><strong>Results: </strong>Forty-one US patients from 31 sites were eligible, and 29 of 41 completed both interviews. Most of the participating patients were male (62%), White (83%), and of age 65+ years (69%). Three themes were derived: (1) Patients perceived that TURBT interfered more with their routine/responsibilities. (2) Urinary symptoms were perceived to be similar, but bleeding, catheter issues, and time to resuming sexual activity lasted longer with TURBT. For UGN-102, uncommon reports were internal itching and difficulty keeping gel in the bladder during instillations. (3) Patients would recommend UGN-102 to other patients because it was perceived to be less invasive, painful, and time-consuming than TURBT.</p><p><strong>Conclusions: </strong>Patients perceived UGN-102 to be a favorable primary treatment alternative to traditional surgical resections for low-grade intermediate-risk nonmuscle-invasive bladder cancer. By focusing on the underexplored area of patient perceptions, this study provides key information urologists will need to conduct shared decision-making conversations.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05243550.</p>","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"18-31"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply by Authors.","authors":"Owen Lewer, Michael D Felice, Olivia Copelan, Sarang Janakiraman, Gaurav Pahouja, Amy Wozniak, Kevin T McVary","doi":"10.1097/JU.0000000000004548","DOIUrl":"10.1097/JU.0000000000004548","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"57"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment.","authors":"Peter Y Cai, Hsin-Hsiao Scott Wang","doi":"10.1097/JU.0000000000004554","DOIUrl":"10.1097/JU.0000000000004554","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"88"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urologic Oncology: Bladder, Penis, and Urethral Cancer, and Basic Principles of Oncology.","authors":"Sam S Chang","doi":"10.1097/JU.0000000000004418","DOIUrl":"10.1097/JU.0000000000004418","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"106-107"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}